Dartmouth-Hitchcock clinic in Keene is touted as 'exemplary'

KEENE - The Dartmouth-Hitchcock Keene Family Medicine department is among 30 clinics nationwide selected as an Exemplar Primary Care Practice by the Robert Wood Johnson Foundation and the MacColl Center for Health Care Innovation at Group Health Research Institute.

Hundreds of practices nationwide were nominated, but only 30 in 20 states were chosen as exemplary models, Brian Austin, associate director at the MacColl Center, said on Tuesday.

Last month, Austin and other team members conducted a three-day site visit of the primary care practice to gather information on its methods, policies and procedures, he said.

The Robert Wood Foundation and the MacColl Center joined forces on the initiative to identify practice innovations that make primary care more efficient, effective and satisfying to patients and providers.

Practices were chosen for their innovations, but also for the different challenges each face. One of the reasons Dartmouth-Hitchcock Keene was chosen was because it provides about 90 percent of the primary care to the surrounding community, Austin said. This gives it a unique vested interest in the health of its community, he said.

It also has a collaborative working relationship with the community's hospital, Cheshire Medical. The primary care and hospital are physically connected, which is convenient for both health professionals and patients.

Together, Cheshire Medical/ Dartmouth-Hitchcock Keene have taken on community health issues, best demonstrated by their Vision 2020 project that aims to make the community the healthiest in the nation by 2020"The health of the community is their responsibility for a large part, and it's one that they seem to have embraced," Austin said.

The primary care practice has cross trained staff so team members can fill in for each other, Austin said. "Clearly you need to use other people in the primary care practice in innovative and inventive ways," he said.

The point of the study is to find ways in which primary care practices can handle an America population that has a growing burden of chronic diseases and how to give the high quality of care needed efficiently, he said.

With that in mind other health professionals, not just doctors, need to be used for primary care, Austin said. Keene tackles this with a nurse triage department that is available to patients by phone or in the office.

"They are pretty rich in R.N. resources. In a lot of places there is not the depth of resources of registered nurses as there is in Keene," Austin said. "Nurse triage is something that a lot of places would like to have."

Leslie Goldman, nurse practitioner in the Department of Primary Care, said her department is honored by the distinction"We want to do the best care that we can and then we want to improve it," she said.